The Community Navigator Service has been commissioned by the Solihull CCG to identify and respond to the health and wellbeing priorities of ‘pre-frail’ people in Solihull. The Community Navigators will be working with a cohort of patients who have been identified through their flu screening and 65+questionnaire.
In doing conducting this research programme, pre-frail people, with their Community Navigator, will be able to stem and deescalate their condition of frailty. This, we believe, can be achieved through a dual approach of meeting any specialist healthcare needs, such as attending a falls clinic, as well as engaging in a positive health and wellbeing related activity which is relevant to their needs.
According to the 2014 Health Profile, the Solihull life expectancy for both men and women is higher than the England average and just slightly short of the ‘England Best’.
Once a patient has been identified as ‘pre-frail’ by their GP, they will be referred to Health Exchange. Below follows the journey once they have joined the service:
1. They will be contacted by a Community Navigator to arrange a home visit.
2. At this initial meeting they will conduct an EASYCare assessment and other appropriate assessment tools.
3. From this assessment we will be able to identify priority concerns regarding the patient’s health and wellbeing.
4. Community Navigators and the patient will agree jointly on what interventions to use regarding any key priorities.
5. This will then be followed up with a review 4-6 weeks after the initial assessment.
6. With the person’s consent, this will be feedback to the GP.
In addition to using the internationally credited EASYCare assessment within the Community Navigator service, EASYCare are also working with Health Exchange in creating a core delivery team to train others in authorised EASYCare practice.